Decreasing Trigger Sensitivity Could Assist PEEP to Further Improve Regional Ventilation Distribution

February 9, 2018 updated by: Jian-Xin Zhou, Capital Medical University

Decreasing Trigger Sensitivity Could Assist PEEP to Further Improve Regional Aeration and Homogeneity During Pressure Assist Ventilation: A Preliminarily Physiological Study

In mechanically ventilated patients during supine position, alveolar collapse usually distributes in dependent lung region.Decrease of flow trigger sensitivity might improve homogeneous of tidal volume distribution.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

In mechanically ventilated patients during supine position, alveolar collapse usually distributes in dependent lung region. High positive end expiratory pressure (PEEP) has been applied to improve the homogeneous distribution of ventilation by increasing the end expiratory lung ventilation (EELV) and alveolar recruitment. However, for patients who increasing PEEP in some extent still existed poor aeration in the dependent region, further elevating PEEP seems to be unreasonable that perhaps lead to overdistension. Decreasing trigger sensitivity might further evoke inspiratory efforts to improve the ventilation for this type of patients.The Electrical impedance tomography (EIT) was applied in monitoring the regional ventilation distribution at the bedside.

Study Type

Observational

Enrollment (Actual)

20

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

    • Beijing
      • Beijing, Beijing, China, 100050
        • Jian-Xin Zhou

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 80 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

The postoperative patients receiving pressure support ventilation and existing heterogenous ventilation.

Description

Inclusion Criteria:

  1. The post operative patients who received pressure support ventilation;
  2. After the clinical PEEP was evaluated 5cmH2O, the tidal volume distribution still existed heterogeneity.

Exclusion Criteria:

  1. Under 18 years;
  2. History of diaphragm dysfunction and surgery;
  3. Central respiratory drive dysfunction;
  4. history of esophageal, gastric or lung surgery;
  5. The contraindication of using EIT (pacemaker, defibrillator, and implantable pumps).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
the lowest trigger sensitivity
The flow trigger of ventilator was set as the lowest level of sensitivity.
The flow trigger will be adjust during the pressure assist ventilation.
the highest trigger sensitivity
The flow trigger of ventilator was set as the highest level of sensitivity.
The flow trigger will be adjust during the pressure assist ventilation.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The homogeneity of distribution of tidal volume
Time Frame: within 20 minutes after changing flow trigger
EIT was used to monitoring the homogeneity of distribution of tidal volume that was divided into two contiguous regions of interest (ROI) equally, the dependent and non-dependent area. The ratio of relative distribution of tidal ventilation of two ROI was calculated.
within 20 minutes after changing flow trigger

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in global and regional EELV
Time Frame: within 20 minutes after changing flow trigger
The change of EELV was measured after changing flow trigger based on the baseline level.
within 20 minutes after changing flow trigger

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Jian-Xin Zhou, MD, Beijing Tiantan Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 1, 2017

Primary Completion (Actual)

August 20, 2017

Study Completion (Actual)

February 1, 2018

Study Registration Dates

First Submitted

August 3, 2017

First Submitted That Met QC Criteria

August 4, 2017

First Posted (Actual)

August 7, 2017

Study Record Updates

Last Update Posted (Actual)

February 12, 2018

Last Update Submitted That Met QC Criteria

February 9, 2018

Last Verified

August 1, 2017

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • KY-2017-001

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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